The paper of postgraduate training in the broad sense for the practice of professional physiotherapist

Esta pesquisa buscou analisar o papel da pós-graduação lato sensu na prática profissional do fisioterapeuta na cidade de Goiânia, enfocando a formação de competência técnica e cognitiva. Foi realizado um estudo quali-quantitativo com uso de questionário semi-estruturado contendo os eixos: o perfil dos egressos, a formação de competência técnica e cognitiva, a relação com o mercado de trabalho e as expectativas dos egressos em relação à pós-graduação lato sensu. Foram analisados 46 questionários respondidos pelos egressos dos cursos de pósgradua ção lato sensu que realizaram o curso no período de 2000 a 2004 e que trabalhavam na cidade no período da coleta. A maioria dos egressos encontrava-se na faixa etária de 20 a 30 anos, era do sexo feminino (78%), concluiu a graduação entre 2001 e 2004 em instituições particulares ou estaduais, nas áreas de conhecimento de fisioterapia hospitalar e neurológica, realizou a especialização entre um e cinco anos após formados e trabalhava em hospitais. Em relação à competência técnica, foi observado que a especialização contribuiu para o aprendizado e aprimoramento de novas técnicas, para melhorar a capacidade de realizar exame físico, diagnóstico e tratamento diferenciado. Quanto à competência cognitiva, observou-se aprimoramento do raciocínio clínico, diminuição das incertezas e inseguranças e melhora da capacidade de comunicação multiprofissional. Verificou-se que a maioria dos egressos percebeu um ganho de crescimento profissional após a especialização. No tocante ao mercado de trabalho, observou-se que ocorreram mudanças de cargo ou promoção com a nova titulação e que apareceram mais oportunidades de emprego, incluindo a docência universitária, porém, a remuneração não se diferenciou. Em relação às expectativas quanto ao curso e aos motivos que os levaram a fazer pós-graduação, a maioria das respostas direcionou o ganho de conhecimento teórico, prático e científico e, também, novas oportunidades de emprego. Para a maioria, as expectativas referentes ao curso foram cumpridas. Dentre os pontos positivos, foram mencionados a presença de ótimos professores, compromissados com a proposta de ensino e, como pontos negativos, a falta de prática na especialização e o sistema de aula mensal, que tornaram o curso cansativo.The present study aimed to show the role of graduate school (lato sensu) on the practice of the physical therapists working in the city of Goiania, state of Goiás, Brazil. The focus was their education focusing on the aspects of knowledge acquisition and technical competence. To achieve these goals the study was designed to have both qualitative and quantitative approaches, using a semistructured questionnaire to obtain data on the profile of the alumni, their cognitive and technical competence, their acquisitions on the job market and their expectations. The research subjects were 46 alumni of lato sensu courses who graduated between the years 2000 and 2004. Results: Most of them had ages between 20 and 30 years, 78% were females, and specialized in hospital and neurological areas. The lato sensu courses were done from one to five years after graduation, and most of the professionals worked at hospitals. According to the subjects, the course contributed for their learning and enhanced their technical competence. They also stated that their confidence was improved by the courses, and that they feel more comfortable working and communicating in multiprofessional environments and teams. Concerning job opportunities, most of the subjects reported more recognition and the appearance of new job opportunities; many were invited for teaching positions, at local universities. But there were no pay rises, in the same function. As for their motivation and expectations to pursue the graduate course, most reported the need to complement their knowledge, in theory and mainly in practice, that is, according to most, insufficient during the undergraduate years. The belief that they would have new job and career opportunities was also manifested. The majority of subjects declared that their expectations were satisfied, and that one major contributor was the quality of the courses and teachers. Some considered the courses to be very intense and tiresome.BV UNIFESP: Teses e dissertaçõe

A Pilot Study of the Breath Stacking Technique Associated with Respiratory Muscle Endurance Training in Patients with Amyotrophic Lateral Sclerosis: Videofluoroscopic Findings in the Upper Airway

Introduction: Bulbar impairment represents a hallmark feature of amyotrophic lateral sclerosis (ALS) that significantly impacts survival and quality of life. Respiratory complications arise because of the weakness of the upper airway and respiratory muscles leading to respiratory failure, impaired swallowing, and reduced airway safety. Breath stacking and respiratory muscle endurance training are techniques that have been described to improve respiratory and bulbar function in patients with ALS. Considering the above, a respiratory technique named TR3 was developed. This study aimed to measure the acute effects of this technique on the upper airway through videofluoroscopy and to assess its clinical trial feasibility in patients with ALS. Material andmethods: In this cross-sectional study, we enrolled participants diagnosed with ALS to perform a single session of TR3. Epidemiological data and baseline assessments were collected. The assessments included kinematics from videofluoroscopy measuring the retropalatal airspace size, the size of the narrowest airway, and the pharyngeal area during rest and TR3. Results: Eight participants were included. During TR3, an acute increase of 15% was observed in the retropalatal airspace size (t = 5.14, p < 0.01), a 123% increase was observed in the size of the narrowest airway (t = –4.18, p < 0.001), and a 277% increase was observed in the pharyngeal area (t = –5.34, p < 0.001). Conclusions: During the intervention, TR3 showed acute effects in increasing pharyngeal constriction, pharyngeal expansion, retropalatal airspace size, and post-lingual narrowest airway size and is feasible for a larger research program. A clinical trial (NCT04226144) is already being conducted to assess the chronic therapeutic effects of this technique and its impact on the clinical evolution of ALS

A pilot study of the breath stacking technique associated with respiratory muscle endurance training in patients with amyotrophic lateral sclerosis: videofluoroscopic findings in the upper airway

Introduction: Bulbar impairment represents a hallmark feature of amyotrophic lateral sclerosis (ALS) that significantly impacts survival and quality of life. Respiratory complications arise because of the weakness of the upper airway and respiratory muscles leading to respiratory failure, impaired swallowing, and reduced airway safety. Breath stacking and respiratory muscle endurance training are techniques that have been described to improve respiratory and bulbar function in patients with ALS. Considering the above, a respiratory technique named TR3 was developed. This study aimed to measure the acute effects of this technique on the upper airway through videofluoroscopy and to assess its clinical trial feasibility in patients with ALS.Material and methods: In this cross-sectional study, we enrolled participants diagnosed with ALS to perform a single session of TR3. Epidemiological data and baseline assessments were collected. The assessments included kinematics from videofluoroscopy measuring the retropalatal airspace size, the size of the narrowest airway, and the pharyngeal area during rest and TR3.Results: Eight participants were included. During TR3, an acute increase of 15% was observed in the retropalatal airspace size (t = 5.14, p < 0.01), a 123% increase was observed in the size of the narrowest airway (t = –4.18, p < 0.001), and a 277% increase was observed in the pharyngeal area (t = –5.34, p < 0.001).Conclusions: During the intervention, TR3 showed acute effects in increasing pharyngeal constriction, pharyngeal expansion, retropalatal airspace size, and post-lingual narrowest airway size and is feasible for a larger research program. A clinical trial (NCT04226144) is already being conducted to assess the chronic therapeutic effects of this technique and its impact on the clinical evolution of ALS

Comparison between breath stacking technique associated with expiratory muscle training and breath stacking technique in amyotrophic lateral sclerosis patients : protocol for randomized single blind trial

Introduction Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting both upper and lower motor neurons, and lead to respiratory failure. Strategies are suggested to respiratory management in ALS patients, as the breath stacking and Expiratory muscle training (EMT), which have been used as aid to assist cough in neuromuscular disorders. However, the randomized controlled trials performed in ALS patients have not investigated the addiction of EMT together breath stacking in this population. This trial aims to determine if breath stacking plus EMT is more effective than breath stacking alone to decrease the decline rate on the inspiratory/expiratory muscle strength, FVC and voluntary PCF in ALS patients. Methods This parallel-group, assessor-blinded randomized controlled trial, powered for superiority, aims to assess pulmonary function, respiratory muscle strength, peak cough flow as primary outcomes. Forty-two participants are being recruited referral neuromuscular disease center at Brasilia, Brazil. Following baseline testing, participants are randomized using concealed allocation, to receive either: a) breath stacking technique alone or b) breath stacking technique plus EMT. Conclusion There is a lack of evidence regarding the benefit of EMT plus breath stacking in ALS patients. This trial will contribute to evidence currently being generated in national and international trials by implementing and evaluating a respiratory therapy program including two components not yet combined in previous research, for people with ALS involving longer-term follow-up of outcomes. This trial is ongoing and currently recruiting.Faculdade UnB Ceilândia (FCE)Curso de Fisioterapia (FCE-FISIO